51
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Maheu E. [Erosive hand osteoarthritis]. LA REVUE DU PRATICIEN 2012; 62:635-641. [PMID: 22730789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Erosive hand osteoarthritis is a form of hand osteoarthritis. Phase of the normal process or separate entity? This remains debated. It is defined by radiographic erosions with a central subchondral bone collapse. It is more frequent than initially described as recently evidenced by ultrasonographic and MRI images which have shown better sensitivity to detect erosions and osteophytes than conventional radiographs. Synovitis, detectable by Doppler ultrasonography, is a common feature. The classical clinical picture is made of inflammatory flares with severe pain, joint swelling and important functional impairment. It leads to severe joint destruction, with major deformations and sometimes ankylosis with mobility restriction. It carries high consequences in terms of aesthetic discomfort, functional impairment and impact on quality of life, justifying the earliest diagnosis as possible and a tight management using, among many other options, local and general anti-inflammatory therapeutics.
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Mondal AK, Lal NR, Kumar P. A boy with claw fingers. Indian Pediatr 2012; 49:255. [PMID: 22484758 DOI: 10.1007/s13312-012-0051-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Contractures of the intrinsic muscles of the fingers disrupt the delicate and complex balance of intrinsic and extrinsic muscles, which allows the hand to be so versatile and functional. The loss of muscle function primarily affects the interphalangeal joints but also may affect etacarpophalangeal joints. The resulting clinical picture is often termed, intrinsic contracture or intrinsic-plus hand. Disruption of the balance between intrinsic and extrinsic muscles has many causes and may be secondary to changes within the intrinsic musculature or the tendon unit. This article reviews diagnosis, etiology, and treatment algorithms in the management of intrinsic contractures of the fingers.
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54
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Nampei A, Shi K, Hirao M, Murase T, Yoshikawa H, Hashimoto J. Association of pinch strength with hand dysfunction, finger deformities and contact points in patients with rheumatoid arthritis. Clin Exp Rheumatol 2011; 29:1061. [PMID: 22132810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 09/06/2011] [Indexed: 05/31/2023]
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55
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Kasparis C, Gach JE. A nonhealing self-mutilation ulcer secondary to neonatal Erb palsy. J Am Acad Dermatol 2011; 65:e145-6. [PMID: 22000883 DOI: 10.1016/j.jaad.2010.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 06/19/2010] [Accepted: 07/06/2010] [Indexed: 11/30/2022]
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56
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Micheroli R, Kyburz D, Ciurea A, Tamborrini G. [The rheumatic hand - diagnostics in practice]. PRAXIS 2011; 100:1097-1106. [PMID: 21932198 DOI: 10.1024/1661-8157/a000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many rheumatic diseases show changes and are visible in the hands. The pattern of distribution in the relevant joints, soft-tissue changes, skin manifestations, neurological and vascular symptoms and clinical findings provide fundamental information. Imaging and lab results provide diagnostic support. In this review, common diseases are presented in terms of their clinical expressions in the hands: osteoarthritis, rheumatoid arthritis, gout, calcium pyrophosphate dihydrate deposition disease, psoriatic arthritis, reactive arthritis, systemic sclerosis, dermatomyositis/polymyositis and systemic lupus erythematosus. Furthermore, we discuss pathological findings of the hands as a result of diabetic cheiroarthropathia, endocarditis, secondary hypertrophic osteo-arthropathy and chronic regional pain syndrom.
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Suyanı E, Yağcı M, Sucak GT. Complete remission with a combination of lenalidomide, cyclophosphamide and prednisolone in a patient with incomplete POEMS syndrome. Acta Haematol 2011; 126:199-201. [PMID: 21849771 DOI: 10.1159/000329896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 05/24/2011] [Indexed: 11/19/2022]
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Walther B. [In a 50-year-old patient: minor inflammation and solid nodules. Rheumatoid nodules]. MMW Fortschr Med 2011; 153:5. [PMID: 21776897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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59
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Anoop TM, Mini PN, Jabbar PK. Boutonnière. THE NEW ZEALAND MEDICAL JOURNAL 2011; 124:111-112. [PMID: 21946885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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60
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Alemzadeh-Ansari MH, Alemzadeh-Ansari MJ. New onset of very large tophi in a patient after kidney transplantation. Clin Med Res 2011; 9:103-4. [PMID: 21562137 PMCID: PMC3134436 DOI: 10.3121/cmr.2011.982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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61
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Chung KC, Pushman AG. Current concepts in the management of the rheumatoid hand. J Hand Surg Am 2011; 36:736-47; quiz 747. [PMID: 21463736 PMCID: PMC3086569 DOI: 10.1016/j.jhsa.2011.01.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Accepted: 01/17/2011] [Indexed: 02/02/2023]
Abstract
Hand surgeons are an integral part of the management team for patients with rheumatoid arthritis. There is now a greater understanding of the national use of rheumatoid hand surgery, which highlights the differences between hand surgeons and rheumatologists regarding the treatment of the rheumatoid hand. Advances in medical treatments have also decreased the prevalence of hand deformities caused by this disease. Hand surgeons today have less exposure to treating rheumatoid hand, but despite more effective medical options, surgery may still offer patients hope for improvement of hand function and appearance. This article summarizes the current state of rheumatoid hand surgery and discuss the surgical treatment strategies for optimizing outcomes for patients with rheumatoid arthritis.
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MESH Headings
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/diagnosis
- Arthritis, Rheumatoid/therapy
- Education, Medical, Continuing
- Female
- Follow-Up Studies
- Hand Deformities, Acquired/etiology
- Hand Deformities, Acquired/physiopathology
- Hand Deformities, Acquired/therapy
- Hand Strength
- Humans
- Male
- Metacarpophalangeal Joint/diagnostic imaging
- Metacarpophalangeal Joint/physiopathology
- Metacarpophalangeal Joint/surgery
- Orthopedic Procedures/methods
- Pain Measurement
- Physical Therapy Modalities
- Radiography
- Range of Motion, Articular/physiology
- Severity of Illness Index
- Tendon Injuries/etiology
- Tendon Injuries/physiopathology
- Tendon Injuries/surgery
- Treatment Outcome
- Wrist Joint/diagnostic imaging
- Wrist Joint/physiopathology
- Wrist Joint/surgery
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Hou CS, Hao ZM, Lei J. [Correction of claw hand deformity after burns by elastic traction]. ZHONGHUA ZHENG XING WAI KE ZA ZHI = ZHONGHUA ZHENGXING WAIKE ZAZHI = CHINESE JOURNAL OF PLASTIC SURGERY 2011; 27:107-110. [PMID: 21774348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To investigate a new method for correction of claw hand deformity after burns. METHODS From May 2006 to Jul. 2010, 12 patients with claw hands deformities after burns were treated with skin grafts (11 hands) and skin flap (1 hand) with unsatisfactory results. Then elastic traction (skin traction or skeletal traction) were performed with individual functional brace. RESULTS All patients were followed up for 0.5 to 2 years. Elastic traction was effective in the correction of metacarpophalangeal joint deformity, buttonhole deformity, thumb-in-palm deformity, scar contracture, and palmar arch deformity. CONCLUSIONS Elastic traction is a simple and effective way for the correction of claw hand deformity after burns with less morbidity and stable results.
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Abstract
Digital deformities result from rheumatoid synovitis. These deformities are easier to treat in the early stage, when the deformity is passively correctable. Treatment options become limited as the disease progresses and the deformity becomes fixed. Surgical treatment of digital deformities is last in the priority of surgical procedures for the rheumatoid hand and wrist. It is therefore important to understand the patient's needs and expectations for improvement and attempt to match them with the surgical options that can predictably improve the patient's function. A close collaboration with the patient's rheumatologist is helpful in the overall management of patients.
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Abstract
Rheumatoid arthritis (RA) is a progressively destructive disease. Gradual loss of hand function in RA patients affects their ability for self-care and interferes with their productivity in society. The continuing improvement in the medical management of RA has markedly decreased the incidence of RA hand surgery. In contrast to RA, osteoarthritis (OA) has less inflammatory reaction in the joints and is characterized by degradation of cartilage, resulting in joint destruction and osteophyte formation. The initial treatment of OA is medication and therapy. Steroid injection into affected joints can provide short-term relief, though repeat injections carry a cumulative risk of weakening the soft tissue. In this article the authors share their extensive experience in RA and OA hand surgery to provide a clear discussion of the indications and outcomes of its practice.
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Wilde GE, Adler RS. Sonographic evaluation of enchondroma with soft tissue extension in the setting of Ollier disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1849-1853. [PMID: 21098859 DOI: 10.7863/jum.2010.29.12.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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66
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Melone CP, Polatsch DB, Beldner S, Khorsandi M. Volar plate repair for posttraumatic hyperextension deformity of the proximal interphalangeal joint. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2010; 39:190-194. [PMID: 20512172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Traditionally, flexor digitorum superficialis tenodesis has been recommended for surgical correction of posttraumatic proximal interphalangeal (PIP) joint hyperextension deformity resulting from recurrent volar plate (VP) disruption. In contrast, VP repair has been used sparingly to restore joint stability, because of concerns regarding excessive scarring, insufficient substance, and the often long time between injury and repair. In the study reported here, we critically evaluated the long-term functional outcome of isolated VP repairs for chronic dorsal instability of the PIP joint performed over an 18-year period. Twenty-five patients underwent surgery for hyperextension deformity of the PIP joint. Mean time from injury to repair was 8.2 years. All patients complained of painful locking of the PIP joint in extension. Precise repair of the VP was performed by meticulous scar lysis and advancement to the anatomical site of insertion while avoiding the adjacent nutrient vessels. Follow-up evaluation included completion of the DASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire and digital mobility, strength, and radiographic assessment. At a mean follow-up of 8 years, we found consistent alleviation of pain, restoration of joint stability, mean arc of motion ranging from 6 degrees to 92 degrees of flexion, and grip strength returned to within 90% of the contralateral side. All patients returned to unrestricted activities.
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67
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Sroa N, Zirwas MJ, Bechtel M. Multicentric reticulohistiocytosis: A case report and review of the literature. Cutis 2010; 85:153-155. [PMID: 20408515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report a case of multicentric reticulohistiocytosis (MRH) demonstrating classic clinical and histologic findings. This rare idiopathic disease is manifested by severe destructive polyarthritis and papulonodular mucocutaneous lesions. The characteristic clinical and histologic findings are discussed as well as the workup and treatment of the disease.
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Torok KS, Baker NA, Lucas M, Domsic RT, Boudreau R, Medsger TA. Reliability and validity of the delta finger-to-palm (FTP), a new measure of finger range of motion in systemic sclerosis. Clin Exp Rheumatol 2010; 28:S28-S36. [PMID: 20576211 PMCID: PMC2935276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Accepted: 04/20/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To determine the reliability and validity of a new measure of finger motion in patients with systemic sclerosis (SSc), the 'delta finger-topalm' (delta FTP) and compare its psychometric properties to the traditional measure of finger motion, the finger-topalm (FTP). METHODS Phase 1: The reliability of the delta FTP and FTP were examined in 39 patients with SSc. Phase 2: Criterion and convergent construct validity of both measures were examined in 17 patients with SSc by comparing them to other clinical measures: Total Active Range of Motion (TAROM), Hand Mobility in Scleroderma (HAMIS), the Duruoz Hand Index (DHI), Health Assessment Questionnaire (HAQ), and modified Rodnan skin score (mRSS). Phase 3: Sensitivity to change of the delta FTP was investigated in 24 patients with early diffuse cutaneous SSc. RESULTS Both measures had excellent intra-rater and inter-rater reliability (ICC 0.92 to 0.99). Fair to strong correlations (rs=0.49-0.94) were observed between the delta FTP and TAROM, HAMIS, and DHI. Fair to moderate correlations were observed between delta FTP and HAQ components related to hand function and upper extremity mRSS. Correlations of the traditional FTP with these measures were fair to strong, but most often the delta FTP outperformed the FTP. The effect size and standardised response mean for the mean delta FTP were 0.50 and 1.10 respectively, over a 2-8 month period. CONCLUSIONS The delta FTP is a valid and reliable measure of finger motion in patients with SSc which outperforms the FTP.
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Kapoor SK, Kataria H, Patra SR, Boruah T. Orthopaedic/radiology/pathology conference: Multiple nodular outgrowths in the hands and feet of a 60-year-old man. Clin Orthop Relat Res 2010; 468:637-42. [PMID: 19459021 PMCID: PMC2806983 DOI: 10.1007/s11999-009-0898-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 05/05/2009] [Indexed: 01/31/2023]
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70
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71
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Cetin C, Köse AA, Karabağli Y, Ozyilmaz M. LYOPHILISED POLYURETHANE MEMBRANE DRESSING FOR SURGICALLY-SEPARATED PSEUDOSYNDACTYLY IN EPIDERMOLYSIS BULLOSA. ACTA ACUST UNITED AC 2009; 37:245-7. [PMID: 14582761 DOI: 10.1080/02844310310016430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The results of paraffin gauze dressing and lyophilised polyurethane membrane dressing were studied in a patient with surgically-separated pseudosyndactyly of dystrophic epidermolysis bullosa. Polyurethane membrane dressing decreased the time to epithelialisation and the need for anaesthesia.
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72
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Heijnen ICM, Franken RJP, Bevaart BJW, Meijer JWG. Long-term outcome of superficialis-to-profundus tendon transfer in patients with clenched fist due to spastic hemiplegia. Disabil Rehabil 2009; 30:675-8. [PMID: 17852274 DOI: 10.1080/09638280701371394] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Spastic hemiplegia is a common feature after stroke, which can result in a clenched fist deformity with secondary hygienic problems and pain. Operative treatment can improve these problems, although literature about its long-term effects is lacking. PURPOSE To determine whether Superficialis-to-Profundus tendon (StP-) transfer procedure leads to permanent improvement of hygiene and reduction of pain in patients with clenched fist due to spastic hemiplegia following stroke. METHOD Patients who underwent a StP-transfer in 2003-2005 were evaluated on skin condition, upper extremity joint mobility, resting position and muscle tone and with VAS scores on hygiene maintenance and pain in the hand. RESULTS Six patients (mean age 54 years; duration after stroke 10 years) were included. Indications to operate were hygienic problems only (3) or combined with pain (3). The average follow-up period was 19 months. After 6 weeks of post-operative splinting, no standard follow-up was applied. Serious post-operative complications were not reported. At follow-up no hygienic problems were present and pain was decreased in all except one patient. All hands could passively be fully opened. In resting position, flexion was seen in the MCP-joints (60-90 degrees). Muscle tone was raised in flexors of the wrist and fingers and m. adductor pollicis (Ashworth 1-2). Given the same pre- and post-operative circumstances, all patients would agree to have the surgery over again. CONCLUSION Even 19 months after the StP-transfer for clenched fist, all operated hands could still be fully opened and there was a permanent improvement of hygiene and pain reduction.
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73
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Eder L, Chandran V, Gladman DD. From ankylosis to pencil-in-cup deformity in psoriatic arthritis: a case report. Clin Exp Rheumatol 2009; 27:661-663. [PMID: 19772803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 56-year-old woman with psoriatic arthritis is presented whose initially ankylosed digit was later found to develop pencil-in-cup change. The patient was treated over that period with etanercept and had no signs of active arthritis. The possible mechanisms for these changes are discussed.
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74
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Barthel A, Bornstein SR, Benker G. [What do the face and hands reveal?]. MMW Fortschr Med 2009; 151:5. [PMID: 19537623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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75
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Goubier JN, Teboul F. Restoration of active fingers flexion with tensor fascia lata transfer in total brachial plexus palsy. Tech Hand Up Extrem Surg 2009; 13:1-3. [PMID: 19276917 DOI: 10.1097/bth.0b013e3181818832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In total brachial plexus palsy, fingers flexion restoration is a real challenge. Nerve surgery can generally restore shoulder abduction and elbow flexion. However, results of nerve grafts or nerve transfers are generally poor for hand function. As a matter of fact, the long distance between nerve sutures and terminal nerve branches in muscles decreases the rate of reinnervation. When finger flexion occurs, strength is generally weak and function remains fair. Therefore, we proposed a new technique to restore fingers flexion. The tensor fascia lata tendon is harvested and sutured between the biceps and flexor digitorum profundus (FDP) tendons. When elbow is flexed, the biceps muscle contraction pulls FDP tendons resulting in a partial but strong hand occlusion. This technique is an alternative to free muscle transfers or nerve surgery with reliable results.
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Shah AK, Clatworthy MR, Watson CJE. Diabetic cheiroarthropathy following simultaneous pancreas-kidney transplantation. Transpl Int 2009; 22:670-1. [PMID: 19175542 DOI: 10.1111/j.1432-2277.2008.00825.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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77
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Degreef I, De Smet L. Multiple simultaneous mallet fingers in goalkeeper. HAND SURGERY : AN INTERNATIONAL JOURNAL DEVOTED TO HAND AND UPPER LIMB SURGERY AND RELATED RESEARCH : JOURNAL OF THE ASIA-PACIFIC FEDERATION OF SOCIETIES FOR SURGERY OF THE HAND 2009; 14:143-144. [PMID: 20135744 DOI: 10.1142/s0218810409004396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 06/22/2009] [Accepted: 09/15/2009] [Indexed: 05/28/2023]
Abstract
The mallet finger is a common hand injury in sports with ball use. Here, we present the case of a goalkeeper with simultaneous bilateral mallet fingers in the third and fourth ray, successfully treated with splinting. Origin and treatment options are discussed.
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78
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Mahlberg MJ, Levis WR. Lepromatous leprosy. Dermatol Online J 2008; 14:27. [PMID: 19061626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Lepromatous leprosy is a form of chronic granulomatous disease that is caused by infection with Mycobacterium leprae. Early involvement is marked by widespread, ill-defined, erythematous papules and plaques. With early intervention, leprosy is a curable disease; however, if not recognized and treated promptly, permanent sequelae and disability result. We present a patient with long-standing lepromatous leprosy who exhibits many of these sequelae.
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79
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Uygur F, Duman H, Celiköz B. Use of free anterolateral thigh perforator flap in the treatment of chronic postburn palmar contractures. Burns 2008; 34:275-80. [PMID: 17493761 DOI: 10.1016/j.burns.2006.10.403] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Accepted: 10/20/2006] [Indexed: 11/24/2022]
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80
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Malaviya GN. ECRL--a wrist extensor with multiple uses in deformity correction. INDIAN JOURNAL OF LEPROSY 2008; 80:1-6. [PMID: 19295115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Extensor carpi radialis longus muscle has been used in various types of procedures for corrective hand surgery and is a favored muscle for correction of finger clawing due to ulnar nerve palsy in leprosy because its removal leaves an insignificant motor deficit and gives a linear scar at the donor site. It is usually not paralyzed in leprosy. The muscle, being phasic, is easy to re-educate. The excursion of the muscle is similar to lumbrical muscles which it substitutes. Since the muscle is dorsally located, the transfer does not lose tension due to adaptive wrist flexing habit. Its tendon is usually thick enough, can be split into two and used as graft to elongate the muscle-tendon unit or for ligament reconstruction in cases of trapezio-metacarpal joint arthritis.
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Yenidunya MO, Seven E. The non-algorithmic nature of the hand burn contractures. Burns 2007; 33:1046-50. [PMID: 17336460 DOI: 10.1016/j.burns.2006.08.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 08/17/2006] [Indexed: 11/20/2022]
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Kloppenburg M, Stamm T, Watt I, Kainberger F, Cawston TE, Birrell FN, Petersson IF, Saxne T, Kvien TK, Slatkowsky-Christensen B, Dougados M, Gossec L, Breedveld FC, Smolen JS. Research in hand osteoarthritis: time for reappraisal and demand for new strategies. An opinion paper. Ann Rheum Dis 2007; 66:1157-61. [PMID: 17360780 PMCID: PMC1955144 DOI: 10.1136/ard.2007.070813] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2007] [Indexed: 01/09/2023]
Abstract
BACKGROUND Osteoarthritis of the hands is a prevalent musculoskeletal disease with a considerable effect on patients' lives, but knowledge and research results in the field of hand osteoarthritis are limited. Therefore, the Disease Characteristics in Hand OA (DICHOA) initiative was founded in early 2005 with the aim of addressing key issues and facilitating research into hand osteoarthritis. OBJECTIVE To review and discuss current knowledge on hand osteoarthritis with regard to aetiopathogenesis, diagnostic criteria, biomarkers and clinical outcome measures. METHODS Recommendations were made based on a literature review. RESULTS Outcomes of hand osteoarthritis should be explored, including patient perspective on the separate components of disease activity, damage and functioning. All imaging techniques should be cross-validated for hand osteoarthritis with clinical status, including disease activity, function and performance, biomarkers and long-term outcome. New imaging modalities are available and need scoring systems and validation. The role of biomarkers in hand osteoarthritis has to be defined. CONCLUSION Future research in hand osteoarthritis is warranted.
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Azizkhan RG, Denyer JE, Mellerio JE, González R, Bacigalupo M, Kantor A, Passalacqua G, Palisson F, Lucky AW. Surgical management of epidermolysis bullosa: Proceedings of the IInd International Symposium on Epidermolysis Bullosa, Santiago, Chile, 2005. Int J Dermatol 2007; 46:801-8. [PMID: 17651160 DOI: 10.1111/j.1365-4632.2007.03313.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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85
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Abstract
Chronic synovialitis of the tendon sheaths and intercarpal joints in rheumatoid patients leads to instability and luxation of the extensor carpi ulnaris tendon and the carpus. Wrist arthrodesis is indicated if the luxation is combined with destruction of the carpal bones. Wrist fusion is the oldest procedure for stabilising the rheumatoid wrist and is still seen as the "gold standard." Patient satisfaction is usually very high. The situation of thin skin combined with subcutaneous atrophy has led to several modifications of the operative procedure over time. Today we are able to achieve high primary stability of the wrist fusion by using a special plate and covering it with soft tissues to avoid internal decubitus. Because of this, patients usually do not need any cast immobilisation, thus making this procedure much more comfortable for these multimorbid patients.
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86
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Ho BK, Morgan JC, Sethi KD. "Starfish" hand. Neurology 2007; 69:115. [PMID: 17606891 DOI: 10.1212/01.wnl.0000267410.94742.d4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zenios M, Ramachandran M, Bellemore MC. Unilateral limb deformity due to fibrous tethers: a report of three cases. J Pediatr Orthop 2007; 27:398-401. [PMID: 17513959 DOI: 10.1097/01.bpb.0000271324.33739.cf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Fibrous tethers are a rare cause of unilateral limb deformity. A review of the literature revealed 9 cases previously described, all located in the distal femur. We report 3 additional cases of fibrous tethers, 2 of which were located in anatomical areas not previously described. The fibrous tethers were excised in all cases, and an osteotomy was performed in 2 of the cases. The clinical, radiological, and histopathologic findings are discussed for each case.
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88
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Field JS, Rizzo M. Madelung deformity with prior distal radius fracture: a case report. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2007; 36:E91-3. [PMID: 17643150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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89
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McGregor JC. The shrinking hand – The sequelae of radiation treatment for a benign skin condition. J Plast Reconstr Aesthet Surg 2007; 60:692-4. [PMID: 17485065 DOI: 10.1016/j.bjps.2006.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Revised: 07/28/2006] [Accepted: 09/03/2006] [Indexed: 11/21/2022]
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90
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Bauer B, Khoa NK, Chabaud B, Chaise F, Quang HT, Comtet JJ. [Flexor digitorum superficialis tendon transfer for intrinsic paralysis in leprosy]. CHIRURGIE DE LA MAIN 2007; 26:136-40. [PMID: 17616418 DOI: 10.1016/j.main.2007.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Revised: 03/30/2007] [Accepted: 04/05/2007] [Indexed: 05/16/2023]
Abstract
A follow up study was performed in the rehabilitation centre for patients with leprosy in Hôchiminhville - Vietnam. All patients had claw-hand deformity due to ulnar and median nerve intrinsic paralysis. Thirty-two affected hands (128 long fingers) were included in the study. A Bunnel-Littler tendon transfer procedure was performed using a four-tailed graft of the flexor digitorum superficialis of the third finger. Clinical evaluation included anatomical measurements of interphalangeal and metacarpal joints in complete extension and in the intrinsic position. In the open hand assessment, 48.5% reported good results, 14.8% medium results and 36.7% poor results. With the hand in the intrinsic position, 53.9% achieved good results, while 33.6% achieved medium results and poor in 12.5%. Poor functional outcome is related to a failure of this procedure and seems to be due to extensor tendon laxity, with or without stiffness of the interphalangeal joints. There were many anatomical deformities (27.3%) found at the time of follow up, notably boutonniere (51.4%) and mallet finger deformities (31.4%) The fourth and fifth fingers had the worst results. We have therefore decided to change our protocol for claw-hand correction and use the Bouvier test in deciding on our surgical indications. Preoperative physiotherapy is absolutely necessary to reduce stiffness of the interphalangeal joints.
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91
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Cil Y, Eski M, Isik S. First dorsal metacarpal artery adipofascial flap for thenar burn contracture releasing. Burns 2007; 34:127-30. [PMID: 17376596 DOI: 10.1016/j.burns.2006.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2006] [Accepted: 08/17/2006] [Indexed: 11/19/2022]
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Starcević B, Bumbasirević M, Lesić A, Radonjić V, Mirić D. [The results of surgical and nonsurgical treatment of mallet finger]. SRP ARK CELOK LEK 2007; 134:521-5. [PMID: 17304767 DOI: 10.2298/sarh0612521s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer) finger. OBJECTIVE Our paper had several research objectives: presentation of the existing results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors' results. METHOD The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center) in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months). An average follow up was 28.7 months. The objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by chi2-test and Student's t-test. The confidence interval was p = 0.05. RESULTS A total range of motion was 51.9 +/- 6.6 for nonsurgically treated patients, and 48.2 +/- 4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5 +/- 3.3 for nonsurgical and 10.0 +/- 3.2 for operated patients. CONCLUSION The results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical method of treating the same deformity.
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Abstract
OBJECTIVE To evaluate upper extremity shortness in patients with hemiplegic cerebral palsy (HCP) and to investigate the association between extremity shortness, motor level, and muscle tone. DESIGN Prospective, controlled study. SUBJECTS Forty-two children with HCP and 29 healthy children. METHODS Radiographs of the involved and the uninvolved humerus, forearm, and hands were obtained with a radiographic ruler placed adjacent to the extremity. The lengths and the diameters of both the diaphyses and metaphyses of the humerus, ulna, radius, and the second and the fifth metacarpal bones were measured in patients and the control group. The discrepancy was calculated as a percentage compared with the normal side. The Ashworth Scale was used in the evaluation of spasticity, and the Brunnstrom recovery staging was used in the motor evaluation. RESULTS Children with HCP had significant differences in bone lengths and diameters compared with control children. There was no significant correlation between the upper extremity Brunnstrom stagings and the differences of bone length and diameter. A significant correlation was observed between the hand Brunnstrom staging and percentage difference of the bone length and diameter. The spasticity level showed no relation to the differences in bone length and diameter. CONCLUSIONS Children with HCP have significant side-to-side limb-length discrepancy when compared with control children. The discrepancy increases with age. The extent of shortening did not appear to be related to upper extremity function and spasticity. The extremity shortness showed a relation to hand function.
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Ashida R, Ihn H, Mimura Y, Jinnin M, Asano Y, Kubo M, Tamaki K. Clinical features of scleroderma patients with contracture of phalanges. Clin Rheumatol 2006; 26:1275-7. [PMID: 17171315 DOI: 10.1007/s10067-006-0490-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 11/03/2006] [Accepted: 11/07/2006] [Indexed: 10/23/2022]
Abstract
Contracture of phalanges (CP) is a frequent complication of patients with systemic sclerosis (SSc). The objective of this study was to examine the prevalance of CP in patients with SSc and investigate the clinical and laboratory features of SSc patients with CP. Three hundred and fifty patients with SSc were examined. CP was found in 164 of the 350 patients (47%) with SSc. The prevalence of oesophageal involvement, pulmonary fibrosis or heart involvement was significantly greater in the patients with CP than that in those without CP. Our study suggested that the presence of CP may be a marker of oesophageal involvement, pulmonary fibrosis and heart involvement.
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Brandsma JW, Schwarz RJ. Re-enablement of the neurologically impaired hand--1: terminology, applied anatomy and assessment. Report of a surgical workshop held at Green Pastures Hospital and Rehabilitation Centre, November 2004, Pokhara, Nepal. LEPROSY REV 2006; 77:317-25. [PMID: 17343219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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98
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Tambuscio A, Governa M, Caputo G, Barisoni D. Deep burn of the hands: Early surgical treatment avoids the need for late revisions? Burns 2006; 32:1000-4. [PMID: 16949210 DOI: 10.1016/j.burns.2006.02.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 02/16/2006] [Indexed: 11/21/2022]
Abstract
An eight years experience in the management of deep hand burns is presented. We reviewed 116 cases of patients surgically treated with escarectomy and skin autograft. Seventy eight of them underwent early surgery within the first 4-6 days from injury, while 38 were conservatively treated in the fist stage and only lately surgery was performed (usually after the 14th day). In all patients, we applied the same post operative topic treatment and rehabilitation protocol. Several months after first admission, only 6(7.7%) of early treated patients needed secondary correction for unaesthetic and functionally debilitating scars versus 14(36.8%) of the late treated group. Our review confirm the importance of performing early surgery of deep burns of the hands, whenever possible, in order to achieve best results and shows it's utility in reducing re-admissions for secondary revisions.
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Ayoub S, Kevat S. Pseudo-rheumatoid deformity in a patient with cerebrovascular disease. Intern Med J 2006; 36:676-7. [PMID: 16958649 DOI: 10.1111/j.1445-5994.2006.01161.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matsubara H, Tsuchiya H, Sakurakichi K, Yamashiro T, Watanabe K, Tomita K. Correction and lengthening for deformities of the forearm in multiple cartilaginous exostoses. J Orthop Sci 2006; 11:459-66. [PMID: 17013733 DOI: 10.1007/s00776-006-1047-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Accepted: 06/12/2006] [Indexed: 12/01/2022]
Abstract
BACKGROUND Multiple cartilaginous exostoses cause various deformities of the epiphysis. In exostoses of the ulna, the ulna is shortened and the radius acquires varus deformity, which may lead to dislocation of the radial head. In this study, we present the results of exostoses resection, with correction and lengthening with external fixators for functional and cosmetic improvement, and prevention of radial head dislocation. METHODS We retrospectively reviewed seven forearms of seven patients who had deformities of the forearm associated with multiple cartilaginous exostoses. One patient had dislocation of the radial head. Operative technique was excision of osteochondromas from the distal ulna, correction of the radius, and ulnar lengthening with external fixation up to 5 mm plus variance. We evaluated radiographs and the range of pronation and supination. Furthermore, we conducted a follow-up of ulnar length after the operation. RESULTS Dislocation of the radial head of one patient was naturally reduced without any operative intervention. At the most recent follow-up, six of the seven patients showed full improvement in pronation-supination. Ulnar shortening recurred with skeletal growth of four skeletally immature patients; however, it did not recur in one skeletally mature patient. Overlength of 5 mm was negated by the recurrence of ulnar shortening about 1.5 years after the operation. CONCLUSIONS We treated seven forearms of seven patients by excision of osteochondromas, correction of radii, and gradual lengthening of ulnas with external fixators. The results of the procedure were satisfactory, especially for function of the elbow and wrist. However, we must consider the possible recurrence of ulnar shortening within about 1.5 years during skeletal growth periods in immature patients.
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